Surgical tool with pair of pivotable jaws

ABSTRACT

A surgical instrument tool including a tubular body having axially extending, diametrically opposed first and second yoke arms formed thereon. The first and second yoke arms each have a respective pivot hole formed therethrough. The tool further including a first jaw having a flange portion formed at one end thereof. The flange portion has first and second opposed faces, and a recess formed in the first face of the flange portion. A first pivot pin extends perpendicularly from the second face of the flange portion of the first jaw through the pivot hole in the first yoke arm to pivotally mount the first jaw on the body. The tool further including a second jaw having a flange portion formed at one end thereof. The flange portion has first and second opposed faces and a connector pin extending perpendicularly from the first face of the flange portion of the second jaw. The connector pin extends into the recess formed in the first face of the flange portion of the first jaw to pivotally couple the first and second jaws. A second pivot pin extends perpendicularly from the second face of the flange portion of the second jaw through the pivot hole in the second yoke arm to pivotally mount the second jaw on the body.

CROSS REFERENCE TO RELATED APPLICATION

This application is a divisional of application Ser. No. 08/582,095,filed Jan. 2, 1996, now U.S. Pat. No. 5,782,749, which is acontinuation-in-part of application Ser. No. 08/241,035, filed May 10,1994, now U.S. Pat. No. 5,480,409.

BACKGROUND OF THE INVENTION

This invention relates in general to surgical instruments and inparticular to an improved structure for a laparoscopic surgicalinstrument.

Laparoscopic surgery is a relatively new operating technique which ismuch less invasive than conventional surgery and, therefore, may beperformed using only a local anesthetic. Such laparoscopic surgeryinvolves puncturing a relatively small opening through the abdominalwall and introducing an inert gas within the abdomen. The introductionof the inert gas expands the abdomen to facilitate access to the bodyparts requiring surgery and visual observation of the procedure. Ahollow cylindrical tube is inserted into the puncture and issubsequently used as a conduit through which one or more elongatedsurgical instruments may be inserted within the abdomen. If desired, aplurality of such relatively small punctures may be formed through theabdominal wall to facilitate the use of several surgical instruments.

A number of laparoscopic surgical instruments are known in the art foruse in laparoscopic surgical procedures. Although they vary widely instructure and operation, such laparoscopic surgical instrumentsgenerally include three basic components. First, a typical laparoscopicsurgical instrument includes a handle which is grasped and manipulatedby the user. The handle may be designed in the general hand of the user.Alternatively, the handle may be designed in the general shape of ahypodermic needle grip for engagement only by the thumb and fingers ofthe user. In either event, the handle usually includes one or moremovable components which can be manipulated by the user for a purposedescribed below.

Second, a typical laparoscopic surgical instrument includes an elongatedshaft portion which extends from the handle. The elongated shaft portionis provided for extending through the hollow cylindrical tube discussedabove during the laparoscopic surgical operation. The elongated shaftportion may include an actuator member which is connected for movementor other operation with the movable component of the handle.

Third, a typical laparoscopic surgical instrument includes a toolportion mounted on the end of the elongated shaft portion. The toolportion is connected to the actuator member of the elongated shaftportion such that movement of the movable component of the handle causesoperation of the tool portion.

As mentioned above, a number of laparoscopic surgical instruments ofthis general type are known in the art. In some of such knownlaparoscopic surgical instruments, the associated tool portions may berotated relative to the handle to a desired orientation by manuallyrotating a thumbwheel fixed to the associated shaft portions. It wouldbe desirable to provide an improved structure for a laparoscopicsurgical instrument of this general type that can be motorized tofacilitate the use thereof. Additionally, in other ones of such knownlaparoscopic surgical instruments, the elongated shaft portions andassociated tool portions are permanently secured to the handle. Thus,the entire laparoscopic surgical instrument must be sterilized ordisposed of after use. It would also be desirable to provide an improvedstructure for a laparoscopic surgical instrument of this general type inwhich the elongated shaft portion and associated tool portion areremovable from the handle. This will allow the relatively inexpensiveelongated shaft portion and associated tool portion to be disposed ofafter use, while allowing the relatively expensive handle to besterilized and reused.

SUMMARY OF THE INVENTION

This invention relates to a surgical instrument including a handleadapted to releasably engage a shaft portion mounting a tool havingrelatively moveable parts. The handle is provided with an actuatingstructure which includes a trigger arm selectively moveable relative tothe handle to cause concurrent movement of the relatively moveable partsof the tool. The actuating structure may include a locking mechanism forreleasably fixing the position of the handle relative to the handle,thus releasably fixing the relative positions of the moveable parts ofthe tool. The handle is also provided with an operating mechanism whichis operatively coupled to the tool to selectively rotate the toolrelative to the handle. The operating mechanism may be motorized. Theoperating mechanism may include a control circuit which can beprogrammed to activate the motor to rotate the tool through specificintervals of displacement is a chosen direction according to selectivemanipulations of control switches. Various objects and advantages ofthis invention will become apparent to those skilled in the art from thefollowing detailed description of the preferred embodiment, when read inlight of the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a laparoscopic surgical instrument inaccordance with this invention showing a first side thereof.

FIG. 2 is another perspective view of the instrument illustrated in FIG.1, showing a second side thereof.

FIG. 3 is an enlarged fragmentary elevational view, partly in section,of the instrument illustrated in FIGS. 1 and 2, with one side piece ofthe handle removed to reveal the interior components thereof.

FIG. 4 is an enlarged elevational view, partly in section, taken alongthe line 4--4 of FIG. 3.

FIG. 5 is an enlarged elevational view, partly in section, taken alongthe line 5--5 of FIG. 3.

FIG. 6 is an enlarged view of the contact shown in FIG. 3.

FIG. 7 is an enlarged elevational view, partly in section, taken alongthe line 7--7 of FIG. 3.

FIG. 8 is a fragmentary elevational view, partly in section, of a secondembodiment of a laparoscopic surgical instrument in accordance with thisinvention.

FIG. 9 is an enlarged elevational view, partly in section, of thereceiver portion shown in FIG. 8.

FIG. 10 is an enlarged elevational view, partly in section, of the toolof the instrument shown in FIG. 8.

FIG. 11 is an elevational view, partly in section, of a third embodimentof a laparoscopic surgical instrument in accordance with this invention,and having an adjustably mounted grip portion.

FIG. 12 is a proximal end view, partly in section, of the instrumentshown in FIG. 11.

FIG. 13 is a view similar to FIG. 11 showing a fourth embodiment of theinstrument of this invention, showing a different structure foradjustably mounting the grip portion of the handle portion.

FIG. 14 is a proximal end view, partly in section, of the instrumentshown in FIG. 13.

FIG. 15 is fragmentary view, partly in section, showing a fifthembodiment of the instrument of this invention, showing a differentstructure for adjustably mounting the grip portion of the handleportion.

FIG. 16 is a view similar to FIG. 15, showing the cam of the lockingmechanism thereof in a lock position.

FIG. 17 is a proximal end view, partly in section, of the instrumentshown in FIGS. 15 and 16.

FIG. 18 is a view similar to FIG. 11 showing a sixth embodiment of theinstrument of this invention, showing a different structure foradjustably mounting the grip portion of the handle portion.

FIG. 19 is a proximal end view of the instrument shown in FIG. 18.

FIG. 20 is a view similar to FIG. 15 showing a seventh embodiment of theinstrument of this invention, showing a different structure foradjustably mounting the grip portion of the handle portion.

FIG. 21 is a view taken along the line 21--21 of FIG. 20, illustratingthe locking mechanism thereof in an unlock condition.

FIG. 22 is a view similar to FIG. 21, illustrating the locking mechanismthereof in an lock condition.

FIG. 23 is a side elevation view of an eighth embodiment of theinstrument of this invention, showing a different structure foradjustably mounting the grip portion of the handle portion.

FIG. 24 is a view similar to that of FIG. 23, partly broken away toillustrate the locking mechanism thereof.

FIG. 25 is an enlarged view of the locking mechanism illustrated in FIG.24.

FIG. 26 is a view taken along the line 26--26 of FIG. 25, showing thelocking mechanism in a lock position.

FIG. 27 is a view similar to that of FIG. 26, showing the lockingmechanism thereof in an intermediate position.

FIG. 28 is a view similar to that of FIG. 26, showing the lockingmechanism thereof in an unlock position.

FIG. 29 is a side elevation view of a ninth embodiment of the instrumentof this invention, showing a different structure for adjustably mountingthe grip portion of the handle portion.

FIG. 30 is a proximal end view of the instrument shown in FIG. 29.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

Referring now to the drawings, there is illustrated in FIGS. 1 through 3a first embodiment of a laparoscopic surgical instrument, indicatedgenerally at 10, in accordance with this invention. The instrument 10includes a pistol-shaped handle 11, a shaft portion 12 which isreleasably secured by the proximal end thereof to the handle 11, and atool 13 secured to the distal end of the shaft portion 12, each of whichwill be described in greater detail below. As used in this application,"proximal" means that portion of the structure under discussion which isnormally close to the user when the instrument 10 is in use. Similarly,"distal" refers to that portion of the structure under discussion whichis farther away from the user holding the instrument 10.

The handle 11 includes a hollow pistol grip portion 14 on top of whichintegrally extends a hollow receiver portion 15. Preferably, thepistol-shaped handle 11 is made of two symmetrical side pieces 16 and17, preferably molded of a plastic material, that are detachablyconnected by conventional means, such as screws 18. Each of the sidepieces 16 and 17 define half of the grip portion 14 and half of thereceiver portion 15. The side pieces 16 and 17 of the handle 11 arepreferably formed of a material which can be repeatedly sterilized in aconventional manner without degrading the performance of the instrument10.

It is anticipated that the handle 11 of the instrument 10 willfrequently be grasped by the grip portion 14 such that the grip portion14 extends generally downwardly toward the floor and the receiverportion 15 is disposed generally upwardly of the grip portion 14 andextends generally horizontally. Therefore, the terms "up", "down","upper", and "lower", and terms of similar import used to describe thelayout of the instrument 10 will be understood to refer to theinstrument 10 while held in that orientation, although the instrument 10may certainly be operated in other orientations.

As shown in FIG. 3, the handle 11 is sized and shaped to contain anoperating mechanism 19 for actuating and rotating the tool 13. In thepreferred embodiment, the portion of the operating mechanism 19 whichrotates the tool 13 is powered by batteries 20 disposed within the gripportion 14. Lithium batteries are preferred for their relatively longshelf life and flat discharge characteristics. It has been estimatedthat two DL123A (3 volt, 1310 milliamp-hour) lithium batteries willoperate the instrument 10 long enough to perform approximately onethousand typical surgical procedures, or approximately two years innormal use. Of course, other battery arrangements may be used. Forexample, a rechargeable battery may be utilized, and provided with anelectrical plug molded through the grip portion 14 to permit rechargingof the battery between uses of the instrument 10. Alternatively, thegrip portion 14 may be provided with a window to permit easy access torelatively frequently replaced disposable batteries contained within thegrip portion 14.

Each of the side pieces 16 and 17 is provided with a rib 21 (only therib 21 on the side piece 17 is shown, in FIG. 3) extending transverselyacross the grip portion 14. The ribs 21 of the side pieces 16 and 17mate to form a bulkhead separating the batteries 20 from the rest of theoperating mechanism 19.

An electrical connector 22 is supported by the ribs 21. The connector 22is electrically connected to and supports one end of the batteries 21. Asecond, similar connector (not shown) is supported by a similar set ofribs (also not shown) traversing a lower part 23 (FIGS. 1 and 2) of thegrip portion 14. This second connector is electrically connected to andsupports the other end of the batteries 20. An electrical conductor 24,electrically connected to the second connector, passes through thebulkhead formed by the ribs 21. The penetrations of the conductor 24 andthe connector 22 through the bulkhead formed by the ribs 21 as well asthe joint between the two opposed ribs 21 are substantially leak-tight,to protect the rest of the operating mechanism 19 in the event ofleakage from the batteries 20.

The battery powered portion of the operating mechanism 19 is preferablyregulated by a control circuit 25. The conductor 24 and the connector 22are electrically connected to the control circuit 25, thereby connectingthe batteries 20 as a power source to the control circuit 25. Thecontrol circuit 25 includes conventional low battery voltage detectioncircuitry (not shown) which controls the operation of a low batteryindicating light 26 (FIG. 2) mounted on the side piece 16. Of course,although only a single low battery indicating light 26 is shown, asecond low battery indicating 26 may be provided in the side piece 17,or the location of the low battery indicating light 26 moved to anydesired location to provide ambidextrous indication of a dischargedbattery condition.

Commands to direct rotation of the tool 13 are input to the controlcircuit 25 by means of a pair of identical thumb switches 27 and 28(FIGS. 1 and 2). The thumb switch 27 is mounted on the side piece 16where it may be conveniently operated by the user's right thumb as theinstrument 10 is held in the user's right hand (FIG. 2). Similarly, thethumb switch 28 is mounted on the side piece 17 where it may beconveniently operated by the user's left thumb as the instrument 10 isheld in the user's left hand (FIG. 1), providing for ambidextrousoperation of the instrument 10.

The thumb switches 27 and 28 are preferably of the conventional rockerswitch type, in which single member, centrally pivoted, may have eitherend depressed to actuate a respective microswitch under the selectedend. A microswitch which is believed to be suitable is available fromC&K Switch of Newton, Mass. By actuating one of the microswitches of thethumb switch 27, the user can direct clockwise rotation of the tool 13;by actuating the other of the microswitches of the thumb switch 27, theuser can direct counter-clockwise rotation of the tool 13. Similarly,the thumb switch 28 can be used to direct clockwise or counter-clockwiserotation of the tool 13.

The control circuit 25 preferably includes a programmable microprocessorto precisely regulate the operation of the operating mechanism 19 inresponse to engagement of the thumb switches 27 and 28. For example, themicroprocessor may be programmed to cause the operating mechanism 19 torotate the tool 13 continuously in the clockwise direction while a firstone of the microswitches of the thumb switch 27 is actuated, stoppingthe tool 13 when the thumb switch 27 is released. The microprocessor canbe programmed to rotate the tool 13 continuously in thecounter-clockwise direction while the other one of the microswitches ofthe thumb switch 27 is depressed, stopping if the thumb switch 27 isreleased or after the tool 13 has rotated a first predetermined amount(such as 360°).

Preferably the microprocessor in the control circuit 25 will beprogrammed to respond to the thumb switch 28 in a manner similar to thatprogrammed for the thumb switch 27. In one suitable ergonomicarrangement, the thumb switches 27 and 28 will be connected to thecontrol circuit 25 such that actuation of the upper microswitch of thethumb switch 27 or the lower microswitch of the thumb switch 28 willresult in clockwise rotation of the tool 13. Similarly, actuation of theupper microswitch of the thumb switch 28 or the lower microswitch of thethumb switch 27 will, result in counter-clockwise rotation of the tool13. Of course, those of ordinary skill in the art will recognize thatthe microprocessor of the control circuit 25 may be programmed tocontrol the rotation of the tool 13 in a variety of ways in response toactuation and release of the thumb switches 27 and 28. For an additionalexample, it is contemplated that the control circuit 25 can be caused tokeep track of the number of times a thumb switch 27 or 28 is actuatedwithin a predetermined period of time, and vary control of the tool 13in response thereto.

The output of the control circuit 25 is directed to a conventional motorassembly 29. The motor assembly 29 includes an encoder 30, a motor 31and a set of reduction gears 32. A motor assembly which is believed tobe suitable is available as Model No. 1219E006GK380 from Micro MoElectronics, Inc., of St. Petersburg, Fla. An output member 33 ispressed onto, or otherwise suitably secured to the output shaft of thereduction gears 32 of the motor assembly 29. In the preferredembodiment, the output member 33 has a generally oval cross-section. Thepurpose of the output member 33 will be explained below.

The motor assembly 29 is supported within a tubular support 35. An axialbore 3 6 is defined through the support 35. A proximal portion 37 of thebore 36 defines a relatively large diameter. A distal portion 38 of thebore 36 defines a relatively small diameter. An intermediate portion 39is defined between the proximal portion 37 and the distal portion 38,and defines a diameter which is smaller than that of the proximalportion 37 but larger than that of the distal portion 38. Thus, a firstshoulder 40 is defined between the proximal portion 37 and theintermediate portion 39 of the bore 36. A second shoulder 41 is definedbetween the intermediate portion 39 and the distal portion 38 of thebore 36. The distal end of the motor assembly 29 is mounted within theproximal portion 37 of the bore 36 with the distal end of the motorassembly 29 abutting the first shoulder 40 within the bore 36 to axiallyposition the motor assembly 29. A pair of opposed set screws 42, whichare threaded into the support 35, engage the motor assembly 29 to retainthe motor assembly 29 in the support 35 and to prevent the motorassembly 29 from rotating relative thereto.

The support 35 has an outwardly extending flange 43 at the distal endthereof. The flange 43, which has a rectangular cross-section, engages amating recess 44 extending about the inner surface of the hollowreceiver portion 15 of the handle 11, so that the support 35 is axiallypositioned and supported within the handle 11 (FIGS. 3 and 4). Thereceiver portion 15 of the handle 11 has a generally rectangularcross-section and thus engages the rectangular flange 43 to preventrotation of the support 35 relative to the handle 11. Preferably therecess 44 provides a close fit with the flange 43, such that a moistureresistant seal is formed therebetween.

A generally cylindrical coupling 45 is provided to transmit torque fromthe output member 33 on the output shaft of the motor assembly 29 to theshaft portion 12 of the instrument 10. The coupling 45 includes a body46 which is preferably molded of a plastic material which transmitstorque well and, for reasons which will be discussed below, has goodelectrical insulation properties. The body 46 has a first axiallyextending recess 47 formed on the proximal end thereof, and has a secondaxially extending recess 48 formed on the distal end thereof. A radiallyoutwardly extending flange 49 is formed on the proximal end of the body45. A circumferential groove 50 is formed in the outer surface of thebody 46, intermediate the flange 49 and the distal end of the body 46.

A hollow metallic insert 51 is preferably secured in the first recess47. The insert 51 may be secured therein using any conventional meanssuch as an adhesive, or molding the body 45 about the insert 51. Theinsert 51 has a cavity 52 adapted to receive the output member 33 of themotor assembly 29 to couple the output member 33 of the motor assembly29 for rotation of the coupling 45.

The flange 49 is rotatable within the intermediate portion 39 of thebore 36 through the support 35. The flange 43 defines a diameter whichis greater than the diameter of the distal portion 38 of the bore 36.Thus, the coupling 46 is prevented from moving away from the motorassembly 29 beyond a first axial position relative to the motor assemblyby the second shoulder 41 of the support 35. The coupling 45 isprevented from moving toward the motor assembly 29 beyond a second axialposition defined where the output member 33 bears against the bottom ofthe cavity 52 in the insert 51 in the proximal end of the coupling 45.The fit of the output member 33 within the cavity 52 in the insert 51 issuch that the coupling 45 can move axially between the first and secondaxial positions relative to the motor assembly 29. The coupling 45 canthus rotate freely with the flange 49 thereof free to move axially to aposition spaced slightly apart from the second shoulder 42 of thesupport 35.

An elastomeric O-ring 53 disposed in the groove 50 and bears against thedistal portion of the bore 36 through the support 35, thereby providinga moisture resistant seal between the coupling 45 and the support 35. Itwill be appreciated that the O-ring, cooperating with the coupling 45and the support 35 prevent passage of moisture from the distal end ofthe handle 11 to the proximal end thereof. Recalling the bulkhead formedby the cooperating ribs 21 formed on the side pieces 16 and 17, it willbe further appreciated that the motor assembly 29 and the controlcircuit 25 are thus contained in a moisture-proof compartment. Thus,these electrical components are protected from the various fluids towhich the instrument 10 may be exposed, such as during surgery andduring sterilization. Additionally, the motor assembly 29 and controlcircuit 25 may be shielded against induced voltages from otherelectrical equipment or components which may be in use nearby. Forexample, the compartment in which the motor assembly 29 and controlcircuit 25 are contained may be lined with a conductive foil 54 (showndiagrammatically by a broken line in FIG. 3) to shield these components.

A metallic insert 55 is fixed in the recess 48 formed on the distal endof the coupling 45. As with the insert 51 in the recess 47, the insert55 may be fixed in the recess 48 by conventional means. As seen in FIG.4, the insert 55 is hollow and provided with inwardly extending splines56, the purpose of which will be explained below.

Referring again to FIG. 3, the shaft portion 12 of the instrument 10 aninner rod or actuating member 60 which is moveable within an outer tube61. A circumferential groove 62 is formed intermediate the proximal anddistal ends of the actuating member 60, preferably near the proximal endthereof. The proximal end of the actuating member 60 is formed as anaxially extending flat tongue 63. The tongue 63 extends within theinsert 55 of the coupling 45, and engages the splines 56 therein. Thus,rotation of the coupling 45 by the motor assembly 29 causes theactuating member 60 of the shaft portion 12 of the instrument 10 torotate. In the embodiment illustrated in FIGS. 1 and 2, the distal endof the actuating member 60 (not shown) is fixed to the tool 13 in aconventional manner. Thus, rotation of the actuating member 60 causesthe tool 13 to rotate.

The operating mechanism 19 further includes an actuating structure 65for moving the actuating member 60 axially relative to the tube 61, inorder to actuate the tool 13. The actuating structure 65 can move theactuating member 60 only a relatively short distance. Such movement ofthe actuating member 60 relative to the coupling 45 is accommodated bymovement of the tongue 63 forming the proximal end of the actuatingmember 60 relative to the splines 56 within the insert 55 in thecoupling 45.

The actuating structure 65 includes a trigger arm 66. The trigger arm 66which is preferably made from a plastic material, may be formed as asingle piece, or, as is shown in FIGS. 1 and 2, formed from two matingportions 67 and 68 secured together by suitable conventional means, suchas screws 69. In either case, the lower portion of the trigger arm 66 isprovided with a finger grip 70 for actuating the trigger arm 66. Thefinger grip 70 is preferably formed as an elongate opening through thetrigger arm to aid the user (not shown) in grasping the instrument 10.

The upper portion of the trigger arm 66 is formed as a yoke, having apair of yoke arms 71 and 72 extend on either side of the receiverportion 15 of the handle 11 (as best seen by referring to FIGS. 1, 2,and 5). An aperture 71a is formed through the yoke arm 71. Similarly, anaperture 72a is formed through the yoke arm 72. The purpose of theapertures 71a and 72a will be explained below. A pin 73 extends betweenthe yoke arms 71 and 72, and through the receiver portion 15 of thehandle 11, to pivotally mount the trigger arm 66 on the handle 11 formovement relative thereto.

A bore 74 extends vertically through the upper portion of the triggerarm 66, extending from between the yoke arms 71 and 72 to a centralrecess 75 formed in the distal face of the trigger arm 66. A secondcentral recess 76 is formed on the proximal face of the trigger arm 66.The purpose of the bore 74 and of the recesses 75 and 76 will beexplained below.

A spring 77 or similar resilient structure is provided for urging thetrigger arm 66 to a first position, relatively away from the gripportion 14 of the handle 11. The first position of the trigger arm 66corresponds to the unactuated condition of the tool 13. As will befurther explained below, when the trigger arm 66 is moved toward thehandle 11 to a second position, the tool 13 is actuated. A pin extendsbetween the side pieces 16 and 17, and through a loop in the spring 77to retain the spring 77 in place relative to the handle 11. One arm 77aof the spring 77 is retained in the recess 76 formed in the proximalface of the trigger arm 66, and bears against the trigger arm 66. Theother arm 77b of the spring 77 bears against the grip portion 14 of thehandle 11.

The trigger arm 66 is provided with a releasable locking mechanism 78for selectively retaining the trigger arm 66 (and thus the moveableportions of the tool 13) at substantially any selected position withinthe range of movement thereof. Preferably, the locking mechanism 78 isembodied as a surface feature forming a ratchet 79 and a pawl 80 whichcan easily engage and disengage the ratchet 79 to lock and unlock theinstrument 10 as desired. The ratchet 79 is preferably formed as aseries of laterally extending teeth 81 formed in a convex arc on theunderside of the receiver portion 15 of the handle 11. However, it willbe understood that other surface features, such as slots formed in thehandle 11 may be suitably used. The pawl 80 is reciprocal in the bore 74of the trigger arm 66 to selectively engage and disengage the ratchet79. Preferably the upper surface of the pawl 80 is provided with aplurality of laterally extending teeth 82 arranged on a concave arc.This arcuate arrangement of the teeth 81 and 82 permits multiple teeth82 of the pawl 80 to engage the teeth 81 of the ratchet 79 at any pointin the travel of the trigger arm 66. Thus, multiple ones of the teeth 81and 82 can share any loads which may be experienced.

The pawl 80 is pivotally connected to a toggle arm 83 which in turn ispivotally connected to a bell crank lever 84. The lever 84 has arms 84aand 84b formed at an angle to one another. The lever 84 is pivotallymounted within the recess 75 on the distal face of the trigger arm 66.The arm 84a of the lever 84 and the toggle arm 83 form a toggle jointsuch that if the user presses the arm 84a or the toggle arm 83 inwardlyinto the recess 75, the pawl 80 will be moved upwardly into engagementwith the ratchet 79. The user presses the arm 84b inwardly into therecess 75 to cause the lever 84 to pivot the arm 84a outwardly. This inturn causes the toggle arm 83 to pull the pawl 80 out of engagement withthe ratchet 79. Thus the user can selectively lock or unlock the triggerarm 66 in the first position thereof, the second position thereof, or atany intermediate position by pressing a finger against, respectively,the arm 84a or the arm 84b of the lever 84.

As most clearly shown in FIG. 5, a trunnion 85 extends between the yokearms 71 and 72 of the trigger arm 66 and through openings 86 and 87 in,respectively, the side pieces 16 and 17 of the handle 11. As shown bythe broken line in FIG. 3, the opening 87 in the side piece 17 is anelongated oval with sufficient clearance to accommodate the movement ofthe trunnion 85 as the trigger arm 66 is moved between the first andsecond positions thereof. The opening 86 in the side piece 16 has asimilar shape.

The trunnion 85 includes a generally cubical receiver portion 88. Thereceiver portion 88 has a pair of relatively smaller cylindricalextensions 89 extending out of opposed faces. The extensions 89 extendthrough the openings 86 and 87 in the side pieces 16 and 17 to engagerespective ones of the apertures 71a and 72a in the yoke arms 71 and 72of the trigger arm 66. The lateral faces of the receiver portion 88 bearagainst the side pieces 16 and 17 to secure the trunnion 85 laterallyrelative to the receiver portion 15 of the handle 11. The trunnion 85 isprovided with a first bore 90 extending from a first end 91 of thetrunnion to a point adjacent a second end 92 of the trunnion. Thus thefirst bore 90 forms a recess in the first end 91 which extends more thanhalf way, but not all the way, through the trunnion 85. Additionally, asecond bore 93 extends horizontally through the middle of the trunnion85 perpendicular to, and communicating with, the first bore 90. Theactuating member 60 of the shaft portion 12 extends through the secondbore 93.

A detent 94 is mounted for reciprocation in the first bore 90 in thetrunnion 85. The detent 94 is generally cylindrical, and includes afirst generally cylindrical bearing portion 95, a receiver portion 96formed as a flat plate, a second cylindrical bearing portion 97, and areduced diameter cylindrical guide portion 98. The bearing portions 95and 97 slidingly engage the surface of the first bore 90 of the trunnion85 to radially position the detent 94. A pear-shaped opening 99 isformed through the receiver portion 96 of the detent 94. The actuatingmember 60 extends through the pear-shaped opening 99. The pear-shapedopening 99 is oriented such that the larger diameter portion 100 thereofis closer to the first bearing portion 95 of the detent 94, and thesmaller diameter portion 101 is closer to the second bearing portion 97of the detent 94. The smaller diameter portion 101 of the pear-shapedopening 99 has a vertical diameter which is slightly greater than thediameter of the actuating member 60 at the base of the groove 62therein, and less than the diameter of the actuating member 60 adjacentto the groove 62. The larger diameter portion 100 of the pear-shapedopening 99 has a vertical diameter which is slightly greater than thediameter of the actuating member 60 adjacent to the groove 62. Thus,when the detent 94 is positioned such that the actuating member 60passes through the larger diameter portion 100 of the pear-shapedopening 99, the actuating member 60 may be moved axially relative to thedetent 94. Thus the detent 94 is in a disengaged position. However, whenthe groove 62 in the actuating member 60 is aligned with the receiverportion 96 of the detent 94, the detent 94 may be moved laterallyrelative to the actuating member 60, such that the receiver portion 96of the detent 94 engages the groove 62. When the actuating member 60 isthus engaged by the detent 94, the axial position of the actuatingmember 60 is fixed relative to the detent 94 within the trunnion 85.Thus, when the trunnion 85 is moved by the trigger arm 66 of theactuating structure 65, the actuating member 60 will move axially withthe detent 94 within the trunnion 85. The detent 94 is thus in theengaged position.

It will be noted that the apertures 71a and 72a in respective yoke arms71 and 72, are moved through an arc by the trigger arm 66, while theactuating member 60 to which the trunnion 85 is fixed reciprocateslinearly. However, the arc of movement of the apertures 71a and 72a isrelatively short, so that little change in vertical position occurs.What little vertical displacement of the trunnion 85 which wouldotherwise occur is accommodated by sizing the apertures 71a and 72a toreceive the trunnion 85 with a relatively loose fit.

A vertical bore 102 is formed through the first bearing portion 95 ofthe detent 94. A pin 103 extends through the bore 102, and is fixed ateither end thereof in the cylindrical extension 89 at the first end 91of the trunnion 85. The bore 102 is laterally elongated, thus permittingthe detent 94 to be reciprocated within the first bore 90 of thetrunnion 85. However, the pin 103 through the bore 102 prevents thedetent 94 from being removed or ejected from the trunnion 85.

A spring 104 or similar resilient structure is provided for urging thedetent 94 toward the engaging position toward the first end 91 of thetrunnion 85. The spring 104 is preferably formed as a coil disposedabout the guide portion 98 of the detent 92, bearing against the secondbearing portion 97 of the detent 92 and the closed end of the first bore90.

When the detent 94 is positioned in the engaging position, the end ofthe first bearing portion 95 extends outwardly beyond the yoke arm 72 ofthe trigger arm 66. As will be further explained below, the user maypush the face of the protruding first bearing portion 95 to move thedetent 94 toward the disengaged position, compressing the spring 104.When the detent 94 is released, the spring 104 urges the detent 94 tomove toward the engaged position thereof.

If desired, means for electrically energizing the actuating member 60may be provided in order to use the instrument 10 for cauterization.Although the concept of using a laparoscopic surgical instrument forcauterization is conventional, the instrument 10 has a unique contactassembly 105 for energizing the actuating member 60 while permittingaxial and rotary relative movement therebetween. As best seen in FIG. 6,the contact assembly 105 includes a socket 106 having a central bore 107through which the actuating member 60 extends. The socket 106 is formedof a conductive solid material, preferably a copper alloy. Acircumferential groove 108 is formed on the inner surface of the socket106, within the bore 107.

A conventional canted coil spring 109 is retained in the groove 108, andprovides a sliding conductive contact with the actuating member 60. Thespring 109 may be formed from a beryllium-copper alloy and then silverplated. A suitable canted coil spring may be obtained from Bal SealEngineering Company, Inc. of Santa Ana, Calif. In the canted coil spring109, the coils are canted to one side about the circumference of thelooped coil. This arrangement permits the actuating member 60 to beinserted through the bore 107 of the disk 105 with reduced effort toexpand the spring 109, when compared to the effort required to insertthe actuating member 60 past a coil spring in which the coils are notcanted.

The socket 106 is provided with a set screw 110 which secures anelectrical conductor 111 to the socket 106. As seen in FIG. 3, theconductor 111 is electrically connected to a plug 112 mounted to extendthrough the handle 11 of the instrument 10. Thus, electrical power forcauterization is supplied to the tool 13 through the plug 112, theconductor 110, the socket 106, the spring 104, and the actuating member60. The patient is electrically grounded in a conventional manner tocomplete the electrical circuit required for cauterization.

The contact assembly 105 further includes a tubular socket housing 113for supporting the socket 106. The socket housing 113 is fixed at theproximal end thereof to the distal face of the receiver portion 88 ofthe trunnion 85. The socket housing 113 holds the socket 106 with thebore 107 in the socket 106 in axial alignment with the second bore 93through the trunnion 85. The socket 106 is captured in the sockethousing 113 by a socket housing cap 114 fixed to the distal end of thesocket housing 113. The socket housing cap 114 is disk-shaped and isformed with a central opening 115, through which the actuating member 60extends into the socket 106. Preferably the distal end of the centralopening 115 is chamfered or otherwise enlarged to ease the alignment andinsertion of the actuating member 60 through the socket housing cap 114.

The socket housing 113 and the socket housing cap 114 are slidinglysupported for reciprocation with the trunnion 85 within a tubular partof the receiver portion 15 of the handle 11. It should be noted thatsufficient clearance must be provided between non-axially moveablecomponents and the reciprocating trunnion 85 and contact assembly 105 toaccommodate relative movement therebetween caused by movement of thetrigger arm 66 between the actuated position and unactuated position.

The distal end of the receiver portion 15 of the handle 11 is formedinto an opening 116, through which the actuating member 60 extends. Acircumferential groove 117 is formed on the inner surface of the distalend of the receiver portion 115, spaced inwardly of the opening 116. Thepurpose of the groove 117 will be explained below.

Referring now to FIGS. 3 and 7, an adapter assembly 118 is provided forreleasably securing the tube 61 of the shaft portion 12 to the handle11. The adapter assembly 118 includes an adapter body 119. The adapterbody 119 is formed with a central opening 120 to accommodate insertionof the shaft portion 12. The adapter body 119 is preferably formed withan annular extension 121 on the proximal end thereof. The extension 121extends into the receiver portion 15 of the handle 11 through theopening 116. The extension 121 is formed with a radially outwardlyextending flange 122 which engages the circumferential groove 117 in thereceiver portion 15 of the handle 11 to retain the adapter body 119 onthe distal end of the handle 11. Preferably the flange 122 fits tightlywithin the groove 117 so that adapter body 119 does not rotate freelyrelative to the handle 11, but rather will remain in a position to whichthe adapter body 119 is rotated by the user. The periphery of theadapter body 119 is preferably scalloped, as seen in FIG. 7, to enablethe user to easily grasp and turn the adapter body 119.

The adapter body 119 is formed with a slot 123 extending linearly acrossthe distal face thereof. Inwardly extending flanges 124 and 125 areformed on either side of the slot 123. An longitudinally extendinggroove 126 is formed in the radially outer surface of the adapter body119 from the base of the slot 123 to the proximal face of the adapterbody 119. A radially inwardly extending recess 127 is formed in theadapter body 119 spaced slightly apart longitudinally from the distalend of the groove 126. The purpose of the slot 123, the groove 126 andthe recess 127 will be explained below. The adapter body is preferablymolded of a suitable plastic material.

The adapter assembly 118 also includes an adapter detent 128. Theadapter detent 128 is preferably a metallic part cast as a flat striphaving a proximally-extending flange 129 formed at one end thereof. Agenerally pear-shaped opening 130 is formed through the adapter detent128. The opening 130 has a wide portion 131, a receiver portion 132, andan elongated narrow portion 133. Preferably, the receiver portion 132 isbeveled outwardly on the distal side thereof, for a purpose which willbe discussed below.

The adapter detent 128 is reciprocally mounted in the slot 123. Theflanges 124 and 125 extend over the adapter detent 128 to retain theadapter detent 128 in the slot 123. The flange 129 is disposed in thegroove 126, and extends over the recess 127. A spring 134 is seated inthe recess 127, and acts to urge the flange 129, and thus the adapterdetent 128, radially outwardly. The detent is prevented from movingradially outwardly out of the slot 123 by a screw 135. The screw 135extends through the narrow portion 133 of the opening 130 and isthreaded into the adapter body 119.

When a user presses the flange 129 radially inwardly, compressing thespring 134, the wide portion 131 of the opening 130 in the adapterdetent 128 is moved into alignment with the opening 115 in the sockethousing cap 114. When the flange 129 is released, the spring 134 movesthe adapter detent 128 radially outwardly until the adapter detent 128is stopped by the screw 135. In this position, the receiver portion 132of the opening 130 is in alignment with the opening 115 in the sockethousing cap 114.

The shaft portion 12 has an adapter bushing 136 fixed about the proximalend of the tube 61. As best seen in FIG. 3, the bushing 136 generallyincreases in thickness toward the distal end thereof. A circumferentialgroove 137 is defined in the bushing 136 spaced from the distal endthereof. When the shaft 12 is installed in the handle 11, the adapterdetent 128 is aligned with the groove 137 on the bushing 136.

The wide portion 131 of the pear-shaped opening 130 has a diameter whichis slightly greater than the diameter of the adapter bushing 136adjacent to the groove 137, but less than the diameter of the distal endof the adapter bushing 136. Thus, when the adapter detent 128 ispositioned such that the wide portion 131 of pear-shaped opening 130 isaligned with the opening 115 in the socket housing cap 114, and thuscentered about the adapter bushing 136, the adapter detent 128 isdisengaged from the adapter bushing 136. When the adapter detent 128 isin this disengaged position, the adapter bushing 136 may be moveddistally out of the adapter detent 128. However, when the groove 137 inthe adapter bushing 136 is aligned with the adapter detent 128, theadapter detent 128 may be moved laterally relative to the adapterbushing 136, such that the receiver portion 96 of the adapter detent 128engages the groove 137. When the adapter bushing 136 is thus engaged bythe adapter detent 128, the position of the adapter bushing 136 isaxially fixed relative to the adapter detent 128 and thus to the handle11 to which the adapter assembly 118 is secured. The adapter detent 128is thus in the engaged position.

As indicated above, the shaft portion 12 is releasably secured to thehandle 11. To install the shaft portion 12, locking mechanism 78 isfirst released, to allow the trigger arm 66 to move distally to thefirst position thereof. Then, the detent 94 and the adapter detent 128are moved to their disengaged positions. This may be easily accomplishedby holding the handle in one hand such that the exposed first bearingportion 95 of the detent 94 is depressed with one finger while flange129 of the adapter detent 128 is simultaneously depressed by the thumbof the same hand. The adapter assembly 118 may be rotated relative tothe handle 11 to the most convenient position for operating the adapterdetent 128. With the adapter detent 128 and the detent 94 held in theirdisengaged positions, the shaft portion 12 is inserted into the opening130 through the adapter detent 128 with the user's other hand. Theactuating member 60 is guided through the contact assembly 105, thetrunnion 85, and into the insert 55 in the coupling 45. As indicatedabove, the distal end of the central opening 115 through the sockethousing cap 114 is chamfered to ease the alignment and insertion of theactuating member 60 through the contact assembly 105. The coils of thespring 109 twist as they are pushed out of the way of the actuatingmember 60 as the actuating member 60 passes through the contact assembly105. The spring 109 bears against the exterior of the actuating member60 to provide an electrically conducting contact. As the actuatingmember 60 is inserted into the coupling 45, the tongue 63 engages thesplines 56 on the interior of the insert 55, thus coupling the actuatingmember 60 for rotation with the motor assembly 29.

As the actuating member 60 is inserted into the handle 11, the adapterbushing 136 on the tube 61 is simultaneously inserted into the adapterassembly 118. The shaft portion 12 is inserted until the adapter bushing136 bears against the distal face of the adapter body 119. The detent 94can then be released to engage the groove 62 on the actuating member 60,and the adapter detent 128 released to engage the groove 137 on theadapter bushing 136. Thus the shaft portion 12 is installed on thehandle 11 with the tube 61 axially fixed relative to the handle 11, andthe actuating member 60 is connected to the operating mechanism 19 forreciprocation and rotation relative to the handle 11.

As indicated above, rotation of the actuating member 60 to rotate thetool 13 will normally cause the tool 13 to rotate the tube 61. This willcause the adapter bushing 136, which is fixed to the tube 61, to rotaterelative to the adapter assembly 118 since the adapter body 119 does notrotate freely relative to the handle 11.

To release the shaft portion 12 from the handle 11, the detent 94 andthe adapter detent 128 are each moved to their respective disengagedpositions. The actuating member 60 and the tube 61 are thus quicklyfreed to permit removal of the shaft portion 12 from the handle 11.

Note that the unique attachment mechanism provided by the detent 94 andthe adapter detent 128 permits rapid and simple removal and replacementof the shaft portion 12. This may be desired during the course ofsurgery, for example, to change from the gripping tool 13 to a scissorstool which would be supported on another shaft portion 12. In previouslyknown instruments, removable shaft portions were secured to respectivehandles by means of a rotating locking ring, thumb screw, or threadedcollar which first had to be rotated to release the shaft portion beforethe shaft portion could be grasped and removed from the handle.

In operation, a user selects the type of tool 13 which is to be used.For the sake of illustration, assume that the user wishes to performsuturing of an internal organ during laparoscopic surgery using aconventional suture needle with an attached ligature or suture. The tool13 chosen by the user would be a gripper as illustrated in FIGS. 1 and2. The user then installs the shaft portion 12 having the selected tool13 onto the handle 11, as described above. Grasping the grip portion 14of the handle 11 with one hand, the user can use fingers of the samehand to move the trigger arm 66 toward the grip portion 14 and therebyactuate the tool 13 to grasp the suture needle (not shown). The userthen actuates the locking mechanism 78 by pressing on the arm 84a of thebell crank lever 84, thus locking the trigger arm 66 in place. Thisallows the user to release the trigger arm 66 without dropping thesuture needle. It will be understood that, as pointed out above, thelocking mechanism 78 is capable of securing the position of the triggerarm 66 relative to the handle 11 at any point in the travel of thetrigger arm 66. This advantageously permits the instrument 10 to belocked grasping any item within the range capable of being grasped bythe tool 13, not merely relatively small objects like a needle.

The instrument 10 is then positioned for use by inserting the tool 13and shaft portion 12 through a laparoscopic guide tube (not shown)installed through a patient's abdominal wall. By manipulating theinstrument 10, the user can pass the needle partially through the tissueto be sutured. While gripping the finger grip 70 of the trigger arm 66with one or two fingers, the user presses on the arm 84b of the lever 84with another finger, causing the locking mechanism 78 to move the pawl80 out of engagement with the ratchet 79, and release the trigger arm66. Since the user was gripping the trigger arm 66, the user can controlthe rate at which the spring 77 moves the trigger arm back to the firstposition thereof, causing the tool 13 to release the needle. The tool 13can then be closed on the protruding portion of the needle to pull itthe rest of the way through the tissue, thus pulling the suture fixed tothe needle through the tissue. The suture is cut between the tissue andthe needle, leaving first and second ends of the suture (not shown)extending from the tissue. The user grasps the first end of the suturein the tool 13. The user depresses a thumb switch 27 or 28 to cause thetool 13 and the tube 61 to rotate three revolutions in a firstdirection. As discussed above, the microprocessor of the control circuit25 can be programmed to cause, for example, a full rotation for a singlemomentary depression of a thumb switch 27 or 28. Simultaneously the usermanipulates a second instrument (not shown), which may be a conventionalgripper tool, to guide the portion of material between the tissue andthe first end of the suture proximally, thus causing the suture to formthree wraps around the tube 61. The first end of the suture is thengrasped by the second instrument, and the tool 13 operated to releasethe first end of the suture. The tool 13 is then moved to grasp thesecond end of the suture, while maintaining the wraps around the tube61. The instrument 10 and the second instrument are then pulledrelatively away from each other, causing the wraps to slide off the tube61 and down around the second end of the suture. Carefully releasing thefirst end of the suture so that the wraps remain around the second endof the suture, the user grasps the second end of the suture with thesecond instrument. Then the user manipulates the instrument 10 torelease the second end of the suture and grasp the first end of thesuture with the tool 13. The user actuates a thumb switch 27 or 28 tocause the tool 13 rotate in the opposite direction from the firstdirection, causing a single wrap to form about the tube 61. Afterexchanging grips once again, without allowing the wrap to slide off thetube 61, the user grasps the second end of the suture in the tool 13,and the first end of the suture with the second instrument. Theinstruments are then pulled apart again to form a slip knot of a typeconventionally used in surgery for securely suturing tissue.

Referring now to FIG. 8, a second embodiment of a laparoscopic surgicalinstrument, indicated generally at 150, in accordance with thisinvention is shown. The instrument 150 includes a pistol-shaped handle151, a shaft portion 152 releasably fixed to the distal end of thehandle 151, and a tool 153 mounted on the distal end of the shaftportion 152.

The handle 151 is preferably constructed of two symmetrical side piecesto form a grip portion 154 and a hollow receiver portion 155, in amanner similar to the handle 11 described above. The handle 151 includesan actuating structure 156, which is structurally similar to theactuating structure 65 described above. The actuating structure 156includes a trigger arm 157 pivotally mounted on the receiver portion 155of the handle 151 for movement relative thereto.

A spring 158 or other resilient structure is provided for urging thetrigger arm 157 to a first position, relatively away from the gripportion 154 of the handle 151. The first position of the trigger arm 157corresponds to the unactuated condition of the tool 153. As with thefirst embodiment described above, when the trigger arm 157 is movedtoward the handle 151 to a second position relatively closer to the gripportion 154, the tool 153 is actuated. The trigger arm 157 is providedwith a releasable locking mechanism, identical in structure andoperation to the locking mechanism 78 described above, for selectivelyretaining the trigger arm 157 in a selected position relative to thegrip portion 154.

The spring 158 is preferably a leaf spring formed from a curved metallicstrap, generally formed as a continuous arc, but having an S-shapedcurve 159 near the proximal end thereof. A first opening 160 is formedthrough the spring 158, spaced slightly from the proximal end thereof Asecond opening 161 is formed through the spring 158 near the distal endthereof. A threaded stud 162, which is fixed to the lower end of thegrip portion 154 extends through the first opening 161 in the spring158. A thumbnut 163 is threaded onto the stud 162 to secure the spring158 to the grip portion 153. Tightening the thumbnut 163 will urge thespring 158 to pivot about a portion of the S-shaped curve 159, urgingthe trigger arm 157 away from the grip portion 154 of the handle 151.Thus, tightening the thumbnut 163 increases the tension in the spring158. Conversely, loosening the thumbnut 163 decreases the tension in thespring 158, thus making it easier for a user to move the trigger arm 157toward the grip portion 154 of the handle 151. In this manner, operationof the thumbnut 163 permits the user to select a desired amount oftension in the spring 158.

The spring 158 is coupled to the trigger arm 157 by a link 164. The link164 is pivotally mounted at a first end thereof in a recess formed onthe proximal side of the trigger arm 157. A hook 165 is formed on asecond end of the link 164 which engages the opening 161 in the distalend of the spring 158 to couple the link 164 and the spring 158. Thespring 158 exerts a force axially through the link 164 to urge thetrigger arm 164 away from the grip portion 154 of the handle 151 asdescribed above. As the trigger arm 157 is moved relative to the gripportion 154 of the handle 151, the link 164 pivots to accommodate theresultant relative motion between the distal end of the spring 158 andthe trigger arm 164.

Referring now to FIG. 9, the receiver portion 155 of the handle 151 hasa pair of opposed oval openings 166 (one of which is shown by a brokenline) formed through the side pieces thereof. A trunnion 167, identicalin structure and function to the trunnion 85 described above, extendsthrough the openings 166 in the receiver portion 155, between the yokearms of the trigger arm 157. Thus, the trigger arm 157 may be moved tomove the trunnion 167 axially within the receiver portion 155.

A bore 168 extends through the trunnion 167 coaxially with the receiverportion 155. A cap 169 is fixed to the proximal face of the trunnion167, sealing the proximal end of the bore 168. A detent 170 isreciprocal within the trunnion 167. The detent 170 has a pear-shapedopening 171 therethrough for releasably engaging the shaft portion 152as will be further described below.

A contact assembly 172, generally similar to the contact assembly 105described above, includes a generally cylindrical socket housing 173fixed to the distal face of the trunnion 167 for movement therewith. Aproximal socket 174 and a distal socket 175, each of which are identicalin structure to the socket 106 described above, are supported within thesocket housing 173. A canted coil spring 176, or other suitable meansfor providing a sliding conductive contact with the shaft portion 152,is captured within a circumferential groove within the bore formedthrough each of the sockets 174 and 175. An electrically insulatingwasher 177 is interposed between the sockets 174 and 175. An annularsocket housing cap 178 is secured to the distal end of the sockethousing 173 to capture the sockets 174 and 175 within the socket housing173. The central openings of the sockets 174 and 175, the insulatingwasher 177, and the socket housing cap 178 are coaxially aligned withthe bore 168 through the trunnion 167.

The sockets 174 and 175 may be electrically energized via respectiveconductors 179 from a conventional bipolar plug 180 extending throughthe proximal end wall of the receiver portion 155 of the handle 151. Asin the first embodiment, the conductors 179 must be sufficiently longand flexible to accommodate the relative movement between the plug 180and the contact assembly 172. The handle 151 preferably includes amolded annular guard 181 about the outwardly projecting portion of theplug 180.

An adapter assembly 182, similar in structure and function to theadapter assembly 118 described above is rotatably mounted on the distalend of the receiver portion 155. The adapter assembly 182 includes abody 183 having an axial bore 184 therethrough. An adapter detent 185having a pear-shaped opening 186 therethrough is reciprocally mounted onthe body 183. As will be further discussed below, the body 183 ispreferably provided with axially-extending grooves 187 to facilitate auser's rotation of the body 183 relative to the receiver portion 155 ofthe handle 151.

Unlike the adapter assembly 118, the adapter assembly 182 includes apair of opposed conventional ball plungers 188. Each ball plunger 188 ismounted by means of external threads thereon in a respective threadedbore 189 extending radially from exterior of the body 183 to the axialbore 184 through the body 183 of the adapter assembly 182. Thespring-loaded balls of each ball plunger 188 extends at least partiallyinto the axial bore 184 of the body 183, for a purpose which will beexplained below.

As illustrated in FIGS. 8 through 10, the shaft portion 152 of theinstrument 150 is generally similar to the shaft portion 12 describedabove. The shaft portion 152 includes an outer tube 190. The interiorsurface of the distal end of the tube 190 is threaded for mounting thetool 153. An adapter bushing 191 is fixed about the proximal end of thetube 190. The adapter bushing 191 has a structure which is similar tothe adapter bushing 136 described above, being tapered inwardly towardthe proximal end thereof, and having a circumferential groove 192 formednear the distal end thereof. A plurality of opposed pairs ofsemi-spherical recesses 193 are spaced about the circumference of theadapter bushing 136 intermediate the groove 192 and the proximal end ofthe adapter bushing 136, the purpose of which will be explained below.

The shaft portion 152 also includes an actuating member 194 which isaxially reciprocal within the tube 190. The proximal end of theactuating member 194 is fixed to a cylindrical connector body 195,preferably by molding the connector body 195 around the distal end ofthe actuating member 194. The distal end of the actuating member 194 maybe knurled or otherwise shaped to improve resistance to being pulled outof the connector body 195.

The connector body 195 is provided with a pair of electrical contacts196 and 197, each made of a suitable electrically conductive material.The contact 196 is generally cylindrical, and has a circumferentialgroove 198 formed about a portion thereof. A reduced diameter distalportion 199 of the contact 196 extends into the proximal end of theconnector body 195. An electrical conductor 200 is electricallyconnected, for example by soldering, to the distal portion 199 of thecontact 196.

The contact 197 is generally tubular and is disposed about the distalportion 199 of the contact 196. The contact 197 is swaged or otherwiseformed to reduce the diameter of a distal portion 201 of the contact197. The inner diameter of the distal portion 201 of the contact 197 isgreater than the outer diameter of the distal portion 199 of the contact196, so that the contact 197 is spaced apart from the contact 196. Thedistal portion 201 of the contact 197 is electrically connected to anelectrical conductor 202.

The contacts 196 and 197 are held in fixed relationship relative to theactuating member 194 by the connector body 195. The connector body 195is preferably formed by insert molding an insulating plastic materialover the distal portions of the contacts 196 and 197, and over theproximal ends of the conductors 200 and 202, along with the proximal endof the actuating member 194 as described above. Thus the proximal endsof the contacts 196 and 197 are left exposed, the purpose of which willbe described below.

Referring now to FIG. 10, the distal end of the actuating member 194 isfixed to a cylindrical connector body 203, preferably by insert moldingthe connector body 203 around the distal end of the actuating member194. The distal end of the actuating member 194 may be knurled orotherwise shaped to improve resistance to being pulled out of theconnector body 203. The conductors 200 and 202 extend through theconnector body 203.

A pair of spaced apart connecting members 204 and 205 extend axiallyfrom the distal end of the connector body 203. The connecting members204 and 205 are fixed to the connector body 203, preferably by insertmolding the connector body 203 about the respective proximal ends of theconnecting members 204 and 205. The connecting members 204 and 205 mayadvantageously be formed from a single U-shaped length of spring wire,the bight (not shown) of which is encased in the connector body 203. Thedistal end of each of the connecting members 204 and 205 is formed intoa respective inwardly extending arm 206 and 207. The connecting members204 and 205 are bent radially outwardly in opposite directions so thatthe arms 206 and 207 are transversely offset from one another. Thepurpose of the arms 206 and 207 will be explained below.

As is best seen in FIG. 10, the tool 153 includes a generally tubularbody 210. The body 210 is provided with threads on the outer surface ofthe proximal end thereof which engage the threads formed on the interiorsurface of the outer tube 190 of the shaft portion 152 to fix the body210 on the distal end of the shaft portion 152. The body 210 has a pairof axially extending yoke arms 211 (FIG. 8) and 212 (shown in brokenline in FIG. 10). A respective pivot hole 214 is formed through each ofthe yoke arms 211 and 212, the purpose of which will be explained below.

The tool 153 her includes a pair of jaws 215 and 216 which are mutuallyrelatively moveable. The jaw 215 includes an elongate gripping portion217. A metallic contact 218 is fixed to the gripping portion 217.Preferably, the contact 218 is formed by stamping, although other formsof forming the contact 218, such as wire forming are also contemplated.The electrical conductor 202 is electrically connected, for example bysoldering, to the contact 218. The gripping portion 217 is preferablyformed of an electrically insulating, rigid plastic material which ismolded about portions of the contact 218 and the distal portion of theconductor 202 to fix the contact 218 to the gripping portion 217 for apurpose which will be discussed below. A flange 220 is formed on theproximal end of the gripping portion 217, preferably being integrallymolded with the gripping portion 217. A pivot pin 221 extendsperpendicularly from the flange 220 into the pivot hole 214 (FIG. 8) ofthe yoke arm 211 adjacent to the jaw 215, the purpose of which will beexplained below. An opening 222 is formed through the proximal end ofthe flange 220, and is engaged by the arm 206 formed on the connectingmember 204. The jaw 215 is thus connected to the connector body 203 foractuation thereby. A connector pin 224 extends from the flange 220opposite the pin 221 to engage a mating recess 225 in a flange 223formed on the jaw 216 with a snap fit, thereby allowing the jaws 215 and216 to be coupled together and pivoted relative to one another.

Except for the recess 225 described above, the jaw 216 is otherwiseconstructed similarly to the jaw 215, having a gripping portion 226formed on the distal end of the flange portion 223. The gripping portion226 is provided with an exposed contact 227 which is electricallyconnected to the conductor 200. Note that since the gripping portions217 and 226 are formed of an electrically insulating material, nocurrent path is provided between the conductors 202 and 200 through thejaws 215 and 216. A second pivot pin (not shown), similar to the pivotpin 221, extends outwardly from the flange portion 223 to engage thepivot hole 214 of the yoke arm 212. The second pivot pin and the pivotpin 221 are coaxially aligned with the connector pin 224 and cooperatewith the pivot holes 214 in the respective adjacent yoke arms 212 and211 to pivotally mount the coupled jaws 215 and 216 to the body 210 ofthe tool 153. An opening 228 is formed through the proximal end of theflange portion 223, which is engaged by the arm 207 on the connectingmember 205. The jaw 216 is thereby connected to the connector body 203for actuation thereby.

The procedure for connecting the shaft portion 152 to the handle 151 isgenerally the same as that for connecting the shaft 12 to the handle 11of the first embodiment, as described above. The locking mechanism isfirst released, to allow the trigger arm 157 to move distally to thefirst position thereof. Then the detent 170 and the adapter detent 185are moved to their disengaged positions. The adapter assembly 182 may berotated relative to the handle 151 to the most convenient position foroperating the adapter detent 185. With the adapter detent 185 and thedetent 170 held in their disengaged positions, the shaft portion 152 isinserted into the opening 186 through the adapter detent 185 with theuser's other hand. The actuating member 194 is guided through thecontact assembly 172, the trunnion 167, and into the cap 169. The spring176 in the socket 174 bears against the electrical contact 196 providean electrically conducting contact therebetween. Similarly, the spring176 in the socket 175 bears against the electrical contact 197 toprovide an electrically conducting contact therebetween.

As the actuating member 194 is inserted into the handle 151, the adapterbushing 191 on the outer tube 190 is simultaneously inserted into theadapter assembly 182. The shaft portion 152 is inserted until theadapter bushing 191 bears against the distal face of the adapter body183. The detent 170 can then be released to engage the groove 198 on theactuating member 194, and the adapter detent 185 released to engage thegroove 192 on the adapter bushing 191. It may be necessary to move thetrigger arm 157 slightly to permit the detent 170 to engage the groove198 on the actuating member 194. The shaft portion 152 is thus installedon the handle 151 with the outer tube 190 axially fixed relative to thehandle 151, and the actuating member 194 is connected to the actuatingstructure 156 for reciprocation with the trigger arm 157.

Additionally, the balls of the ball plungers 188 are axially aligned toengage the recesses 193 on the adapter bushing 191. The recesses 193 maybe engaged by the ball plungers 188 immediately upon insertion of theshaft portion 152 into the handle 151. However, it may be necessary torotate the outer tube 190 and the attached adapter bushing 191 relativeto the handle 151 to radially align a pair of the recesses 193 with theball plungers 188. Once the ball plungers 188 are axially and radiallyaligned with a pair of the recesses 193, the balls of the ball plungers188 will engage respective ones of the recesses 193. The adapter bushing191 and the outer tube 190 are thereby releasably fixed to the adapterassembly 182 for rotation therewith.

In operation, a user (not shown) will grasp the instrument 150 by thehandle 151 with one hand. To rotate the tool 153 to a desiredorientation relative to the handle 151, the user grasps and rotates thebody 183 of the adapter assembly 182. The grooves 187 provide arelatively slip-resistant surface for grasping the body 183. The ballplungers 188 couple the body 183 to the adapter bushing 191 such thatwhen the body 183 is rotated, the adapter bushing 191 and the outer tube190 also rotate. The tool 153 is fixed to the outer tube 190 and thusrotates therewith.

To actuate the tool 153, the user moves the trigger arm 157 from thefirst position thereof proximally to a second position relatively closerto the grip portion 154 of the handle 151. The trunnion 167 consequentlymoves the actuating member 194 proximally within the handle 151, causingthe connector body 203 to move proximally relative to the outer tube190. This in turn causes the connecting members 204 and 205 attached tothe connector body 203 to draw the openings 222 and 228 relativelycloser together, and the gripping portions 217 and 226 to move towardone another. Releasing the trigger arm 157 permits the spring 158 todrive the trigger arm 157 back toward the first position thereof,resulting in the connector body 203 moving relatively toward the tool153. This causes the connecting members 204 and 205 to drive theproximal end of flanges 220 and 223 relatively apart and also causes thegripping portions 217 and 226 to move relatively apart.

As indicated above, the contacts 218 and 227 are electrically isolatedfrom one another by the respective gripping portions 217 and 226 whichare made of an electrically insulating material. A conventionalelectrosurgical generator having a bipolar electrical potential outputmay be connected to the instrument 150 via the plug 180. A user may thenactuate the tool 153 to grasp selected tissue between the jaws 215 and216. The user can then actuate the generator to apply an electricalpotential between the contacts 218 and 227, thereby causing electricalcurrent to flow through the tissue interposed between the contacts 218and 227. This may be desired, for example, to cauterize a wound duringsurgery.

Referring now to FIGS. 11 and 12, a third embodiment of a laparoscopicsurgical instrument in accordance with this invention is shown generallyat 300. The instrument 300 includes a pistol-shaped handle 302, which ispreferably constructed of two symmetrical side pieces to form a hollowreceiver portion 304, in a manner similar to the handles 11 and 151described above. The handle 302 includes an actuating structure having atrigger arm 306 pivotally mounted on the receiver portion 304 of thehandle 302 for movement relative thereto.

The proximal end of the receiver portion 304 is provided with anelongated flange 308 defining a longitudinal axis of the receiverportion 304. The flange 308 has a T-shaped cross section for adjustablymounting a grip portion 310 on the receiver portion 304. As shown inFIG. 12, each half of the receiver portion 304 preferably forms one halfof the flange 308.

The grip portion 310 is preferably constructed of two symmetrical sidepieces, 310a and 310b. Each of the side pieces 310a and 310b is providedwith a respective flange 311 which extends about most of the peripheryof the respective side piece 310a or 310b, and which extends toward theother of the side pieces 310a and 310b. The flanges 311 on the sidepieces 310a and 310b cooperate with the side pieces 310a and 310b togenerally define a hollow interior space 312 within the grip portion310. A discontinuity in the flanges 311 forms a first opening 314 intothe grip portion 310. A second opening 316 into the grip portion 310exposes the T-shaped flange 308 of the receiver portion 304 to theinterior space 312 of the grip portion 310, for a purpose which will bediscussed below.

Each of the side pieces 310a and 310b is provided with a respectivelongitudinally extending recess, 318a and 318b. The recesses 318a and318b cooperate to define a T-shaped slot which receives the flange 308to mount the grip portion 310 for sliding movement relative to thereceiver portion 304 along the longitudinal axis defined by the flange308. Each of the side pieces 310a and 310b is also provided with arespective cylindrical recess, 320a and 320b. The recesses 320a and 320bcooperate to mount a pin 322 therein.

A locking, mechanism is provided for selectively fixing the relativepositions of the grip portion 310 and the receiver portion 304. Thelocking mechanism includes a locking cam 324. The cam 324 has adisc-shaped body 325 and a depending arm 326, which is eccentricallymounted on the pin 322. The arm 326 extends out of the interior space312 of the grip portion 310 through the opening 314, where it may beeasily manipulated by a user of the surgical instrument 300. In a firstposition, illustrated in solid line in FIG. 11, the body 325 of the cam324 is spaced apart from the flange 308, and the grip portion 310 isfree to move longitudinally relative to the receiver portion 304 of thehandle 302. In this manner, a user of the surgical instrument 300 mayadjust the distance between the trigger arm 306 and the grip portion 310as needed to provide a comfortable grip. Once a position is found whichis comfortably fits the size of the user's hand, the arm 326 of the cam324 is operated to move the cam 324 to the lock position illustrated indashed line in FIG. 11. As the cam 324 is rotated into the lockposition, the eccentrically mounted body 325 is urged through theopening 316 into contact with the flange 308. The cam 324 is wedgedagainst the flange 308 in the lock position, fixing the position of thegrip portion 310 on the receiver portion 304.

FIGS. 13 and 14 illustrate a fourth embodiment of a laparoscopicsurgical instrument, indicated generally at 400, in accordance with thisinvention. The instrument 400 includes a pistol-shaped handle 402, whichis generally similar to the handle 302 described above. The handle 402includes a receiver portion 404 having a proximal end which is generallycylindrical. The handle 402 also includes a grip portion 406 which isadjustably mounted on the receiver portion 404.

Unlike the grip portion 310, the grip portion 406 is provided with apair of clamp members 410 and 412. Each of the clamp members 410 and 412has a respective curved wall 414, and a respective ear 416 extendingfrom one longitudinally extending edge of the respective curved wall414. The curved walls 414 of the clamp members 410 and 412 cooperate tosubstantially encircle the proximal end of the receiver portion 404. Theflat plates 416 of the clamp members 410 and 412 are parallel and spacedapart from one another. Each of the flat plates 416 has an apertureformed therethrough. A pin 418 is fixed in the apertures formed in theflat plates 416 of the clamp members 410 and 412, extending between theflat plates 416. The flat plates 416 of the clamp members 410 and 412are fixed to respective halves of the grip portion 406 by any suitablemeans. Note that although the grip portion 406 is preferably formed fromtwo symmetric mating pieces, the grip portion 406 of the laparoscopicsurgical instrument 400, as in the other embodiments of the laparoscopicsurgical instrument of this invention, may be suitably formed as aunitary part, or formed from any suitable number of parts. Also, theclamp members 410 and 412 may be formed as a single piece, or may beformed as integral parts of respective ones of the two halves of thegrip portion 406.

A locking mechanism is provided, which includes a locking cam 420. Thelocking cam 420, similar to the cam 324 described above, iseccentrically mounted on the pin 418. While holding the laparoscopicsurgical instrument 400, the user may use his or her fingers to easilymove the cam 420 from an unlock position (shown in solid line in FIG.13) to a lock position (shown in dashed lines in FIG. 13). In the unlockposition, the cam 420 is disengaged from the receiver portion 404, andthe grip portion 406 may be moved relative to the receiver portion 404.If desired, the grip portion 406 may be rotated relative to the receiverportion 404, as well as being moved longitudinally relative thereto asdepicted by the phantom lines of FIG. 13. When the cam 420 is moved tothe lock position, the cam 420 moves into engagement with the proximalend of the receiver portion 404, and is wedged between the pin 418 andthe receiver portion 404 to fix the position of the grip portion 406 onthe receiver portion 404.

FIGS. 15 through 17 illustrate a fifth embodiment of a laparoscopicsurgical instrument in accordance with this invention, which isindicated generally at 500. The instrument 500 is generally similar tothe instrument 400 described above, and has a grip portion 502adjustably mounted on the cylindrical proximal end of a receiver portion504. The grip portion 502 is fixed to, or integrally formed with a clampmember 510. The clamp member 510 includes a tubular body 512 encirclingthe proximal end of the receiver portion 504. A longitudinally extendingopening 514 is formed through the body 512 opposite to the grip portion502. Adjacent each longitudinally extending edge of the opening 514 is arespective outwardly extending ear 516. The ears 516 are parallel toeach other, and are spaced apart from one another by the transversewidth of the opening 514. A pin 518 is mounted transversely on the clamp510, extending between the ears 516. A locking mechanism is provided,which includes a locking cam 520. The locking cam 520 is eccentricallymounted on the pin 518. The locking cam 520 is similar in function tothe locking cam 420 described above, but mounted on the opposite side ofthe receiver portion 504 from the grip portion 502 of the instrument500.

The locking cam 520 is shown in an unlock position in FIG. 15. In theunlock position, the cam 520 is disengaged from the receiver portion504, and the grip portion 502 may be moved relative to the receiverportion 504. If desired, the grip portion 502 may be rotated relative tothe receiver portion 504, as well as being moved longitudinally relativethereto as depicted by the phantom lines of FIG. 15.

When the cam 520 is moved to the lock position, illustrated in FIG. 15,the cam 520, extending into the opening 514, moves into engagement withthe proximal end of the receiver portion 504. The cam 520 is wedgedbetween the pin 518 and the receiver portion 504 to fix the position ofthe grip portion 502 on the receiver portion 504. The instrument 500 maythus be seen to be very similar in structure and function to theinstrument 400, but having the locking cam 520 mounted to engage theupper surface (as seen in FIGS. 15 through 17) of the receiver portion504 rather than the lower surface thereof.

FIGS. 18 and 19 illustrate a sixth embodiment of a laparoscopic surgicalinstrument in accordance with this invention, which is indicatedgenerally at 600. The instrument 600 is generally similar to theinstrument 500 described above, with three exceptions. The proximal endof a receiver portion 604 of the instrument 600 has a generally squarecross section, rather than a cylindrical one like the receiver portion504 described above. The clamp member 610 includes a hollow body 612also having a generally square cross section loosely conforming to theproximal end of the receiver portion 604. The clamp member 610, and theattached grip portion 614, can thus move longitudinally relative to thereceiver portion, but not rotate relative thereto.

Finally, instead of a locking cam similar to the cam 520 describedabove, the clamp member 610 is provided with a thumb screw 616 for alocking mechanism. The thumbscrew 616 engages a threaded opening 618 inthe body 612, and may be selectively screwed inwardly to engage thereceiver portion 604 to fix the relative positions of the grip portion610 and the receiver portion 604. The thumb screw 616 may be selectivelyloosened to reposition the grip portion 610 on the receiver portion 604.

It will be appreciated that the opening 618 may be provided to mount thethumb screw 616 at other locations on the body 612. For example thethumb screw could be mounted to extend upwardly through the grip portion614 as shown in phantom line in FIG. 18, or through the side of the body614, as shown in FIG. 19. It will be appreciated that the locking cams420 and 520 described above could be mounted to engage the side of theirrespective receiver portions. However such an arrangement may be lessdesirable than the designs illustrated and discussed above, since suchan arrangement would likely be less ambidextrous than the discusseddesigns.

FIGS. 20 through 22 illustrate a seventh embodiment of a laparoscopicsurgical instrument in accordance with this invention, which isindicated generally at 700. The instrument 700 is generally similar tothe instruments described above which have adjustably mounted gripportions. The proximal end of a receiver portion 704 of the instrument700 has a longitudinally extending flange 706 depending therefrom. Notethat although the receiver portion 704 is shown as a single piece, thereceiver portion 704 may suitably be formed from two or more piecesfixed together like, for example, the two symmetrical side piecesforming the receiver portion 304 described above. The flange 706 has acruciform cross section, as shown in FIGS. 21 and 22. As shown in FIG.20, the lower portion of the flange 706 is scalloped, having a pluralityof recesses 708 extending transversely from side to side of the lowersurface of the flange 706. The purpose of the recesses 708 will bedescribed below.

A grip portion 714, formed from a symmetric pair of mating halves 714aand 714b, is slidably mounted on the flange 706. Each of the halves 714aand 714b is formed with respective longitudinally extending recess 716.The recesses 716 cooperate to form a cruciform slot within which theflange 706 is slidably received.

Each half 714a and 714b of the grip portion 714 is formed with arespective cylindrical recess, the two cylindrical recesses cooperatingto define a transversely extending cylindrical bore 718 in the gripportion 714. At each end of the cylindrical bore 718, a square opening(or other non-circular opening) 720 extends through the respective half714a and 714b of the grip portion 714.

A locking pin 722 is slidably disposed within the bore 718. The lockingpin 722 has a cylindrical central portion 724. The central portion 724is shorter in length than the bore 718, so that the locking pin 722 canslide in the bore 718 between a first position, shown in FIG. 21, and asecond position, shown in FIG. 22. A pair of extensions 726 and 728 areformed on respective ends of the central portion 724. The extensions 726and 728 have square cross sections, and extend into respective ones ofthe openings 720. The openings 720 cooperate with the extensions 726 and728 to prevent the locking pin 722 from rotating within the bore 718. Auser of the instrument 700 can move the locking pin 722 transversely tothe first position by pressing against the extension 726, which extendsoutwardly from the grip portion 714 when the locking pin 722 is not inthe first position. The user can move the locking pin 722 to the secondposition by pressing against the extension 728, which extends outwardlyfrom the grip portion 714 when the locking pin is not in the secondposition.

The central portion 724 of the locking pin 722 has a notch 730 whichextends longitudinally (with respect to the axis of the receiver portion704 of the instrument 700) through the upper part (as viewed in FIGS. 21and 22) of the central portion 724 of the locking pin 722. When thelocking pin 722 is placed in the first position, the notch 730 isaligned with the flange 706, as shown in FIG. 21, and the grip portion714 may be selectively moved longitudinally along the flange 706.

The grip portion 714 may be selectively locked in place by the user byaligning the locking pin 722 with one of the transverse recesses 708formed in the flange 706, and then pressing the extension 728 to movethe locking pin to the second position shown in FIG. 22. An unnotchedupper part of the central portion 724 of the locking pin 722 is movedinto the selected one of the recesses 708, thereby preventinglongitudinal movement of the grip portion 714 relative to the receiverportion 704. To unlock the grip portion 714, the user presses againstthe extension 726, moving the locking pin 722 back to the firstposition, and aligning the notch 730 with the flange 706. With the notch730 of the locking pin 722 aligned with the flange 706, the portions ofthe flange 706 between the recesses 708 slide through the notch 730.

The locking pin 722 will preferably fit within the bore 718 with a tightsliding fit, so that friction will hold the locking pin 722 in theposition selected by the user. However, if necessary the locking pin 722can be provided with a circumferentially extending groove within whichan O-ring 750 is mounted. The O-ring 750 is compressed between thelocking pin 722 and the wall of the bore 718 to increase the frictiontherebetween.

It will be understood that the locking mechanism may be formed with alocking pin which prevents relative movement between the grip portion714 and the receiver portion 704 in other ways than described above. Forexample, if a locking pin were provided with an enlarged head (notshown) extending from one end thereof, the locking pin could be movedbetween a first, unlocked position and a second, locked position bymanipulating only the enlarged head. Such a locking pin need not extendcompletely through the receiver portion 704, but could engage a selectedone of a plurality of recesses (not shown) formed on an adjacent side ofthe flange 706. Such recesses could extend completely through the flange706 to form bores (not shown) in which such a locking pin could beselectively inserted.

FIGS. 23 through 28 illustrate an eighth embodiment of a laparoscopicsurgical instrument according to the invention and indicated generallyat 800. A handle portion 802 of the instrument 800 is provided with agrip portion 804 which is adjustably mounted on a receiver portion 806.The receiver portion 806 has a depending flange 808, similar to theflange 308, which has a T-shaped cross section and which cooperates withlongitudinally extending recesses (not shown, but similar to therecesses 318a and 318b described above) to adjustably mount the gripportion 804 on the receiver portion 806.

An L-shaped locating pin 810 is fixed to the receiver portion 806. Thelocating pin 810 has a notched portion 812 which extends parallel to theflange 808. The notched portion 812 of the locating pin 810 has aplurality of circumferentially extending notches 814 formed thereon, asbest seen in FIGS. 24 and 25.

The grip portion 804 is provided with a locking mechanism 816 forselectively engaging the notches 814 on the locating pin 810, therebyselectively fixing the relative positions of the grip portion 804 andthe receiver portion 806. The locking mechanism 816 may be easilyoperated by the user of the instrument 800 to disengage the notches 814to permit the grip portion 804 to be moved longitudinally on the flange808 to a suitable position relative to the receiver portion 806.

As best seen in FIGS. 25 through 28, the latch mechanism 816 includestwo parallel disks 820 and 822. The disks 820 and 822 are arranged inthe grip portion 804 on either side of the locating pin 810. The disks820 and 822 are identical, and the reference numbers assigned tofeatures on the disk 822 described below will also be used to indicatedcorresponding features on the disk 820.

A finger pad 824 is formed on the outer surface of the disk 822. Threespring retaining pins 826 are fixed to the inner surface of the disk 822and extend perpendicularly therefrom, the pins 826 being equally spacedabout the periphery of the inner surface of the disk 822. A grasperattachment pin 828 is fixed to the inner surface disk 822, and extendsperpendicularly therefrom.

A coil spring 830 is seated about each of the spring retaining pins 826on the disks 820 and 822. The springs 830 act to urge the disks 820 and822 apart.

A disk shaped grasper plate 832 is operatively coupled to the disk 822,and another grasper plate 834, identical to the plate 832, isoperatively coupled to the disk 820 for movement therewith. Each of theplates 832 and 834 is provided with a longitudinally extending groove836 on the inner surface thereof.

The plate 832 has a first bore 838 formed therethrough into which thegrasper attachment pin 828, extending from the disk 822, is fixed, suchas by pressing. The grasper attachment pin 828 couples the plate 832 andthe disk 822 with the inner face of the plate 832 facing the inner faceof the disk 822. The plate 834 has a similar first bore 840 formedtherethrough. The associated grasper attachment pin 828 is fixed in thebore 840 to couple the plate 834 and the disk 820 with the inner face ofthe plate 834 facing the disk 820.

The plate 832 has a second bore 842, of slightly greater diameter thanthe first bores 838 and 840. The grasper attachment pin 828 coupling theplate 834 to the disk 820 is slidably disposed within the second bore842. Similarly, the plate 834 has a second bore 844, of the same size asthe bore 842, through which passes the grasper attachment pin 828coupling the plate 832 to the disk 822.

Each of the grasper plates 832 and 834 is provided with a longitudinallyextending groove 846 formed in the inner face thereof. The grooves 846each have a semicircular cross section so that when the plates 832 and834 are pressed against one another, as shown in FIG. 26, the grooves846 cooperate to form a generally cylindrical bore, within which thelocating pin 810 extends. An inwardly extending flange 848 is formed ineach of the grooves 846, which as shown in FIG. 25, can be positioned ina manner described below to engage one of the notches 814 of thelocating pin 810.

As depicted in FIG. 26, the springs 830 urge the disks 820 and 822apart. The grasper plates 834 and 832 are coupled to the associateddisks 820 and 822, and are thus urged together such that theirrespective inner faces are in contact. The flange 848 on each of thegrasper plates 834 and 832 is held in a selected one of the notches 814on the locating pin 810.

To move the grip portion 804 relative to the receiver portion 806, thefinger pads 824 of the locking mechanism 816 are pressed toward eachother by the user, compressing the springs 830. This causes the grasperplates 832 and 834 to be moved apart from one another, as shownprogressively in FIGS. 27 and 28. When the flanges 848 are fullydisengaged from the notch 814, the grip portion 804 may be moved alongthe flange 808 to a desired position. When the flanges 848 are next tothe notch 814 corresponding to the desired position of the grip portion804 on the receiver portion 806, the finger pads 824 of the lockingmechanism 816 are released. The springs 830 urge the flanges 848 intothe selected notch 814. If the finger pads are released in a slightlywrong position, the flanges 848 may engage the locating pin 810 betweenthe notches 814. In this situation, the grip portion 804 may be pushedlongitudinally along the flange 808 until the flanges 848 snap into theselected notch 814 under the urging of the springs 830.

Note that it is contemplated that a locating pin (not shown) similar tothe locating pin 810 could be fixed to the moveable grip portion 804.Likewise, a locking mechanism (not shown) similar to the lockingmechanism 816 could be mounted on the receiver portion 806 and cooperatewith the locating pin on the grip portion 804 to selectively preventmovement of the grip portion 804 relative to the receiver portion 806.

FIGS. 29 and 30 illustrate a ninth embodiment of a laparoscopic surgicalinstrument according to the invention and indicated generally at 900. Ahandle portion 902 of the instrument 900 is provided with a grip portion904 which is adjustably mounted on a receiver portion 906. The gripportion 904 has a flange 908 formed thereon. The flange 908 has aT-shaped cross section and cooperates with a mating slot 910 to mountthe grip portion 904 on receiver portion 906. The slot 910 extends alonga longitudinal axis in the lower surface of the distal end of thereceiver portion 906.

Serrated teeth 912 are formed on the underside of each arm of the flange908 on the grip portion 904, with mating teeth 914 formed on theadjacent surfaces of the slot 910 formed in the receiver portion 906.

A leaf spring 916, or other suitable spring, is fixed to the uppersurface of the flange 908, urging the teeth 912 into engagement with theteeth 914. Axial movement of the grip portion 904 on the receiverportion 906 is thereby prevented by the locking mechanism comprised ofthe spring 916 and the teeth 912 and the teeth 914.

To adjust the position of the grip portion 904 on the receiver portion906, a user presses the grip portion 904 toward the receiver portion906, compressing the spring 916, and disengaging the teeth 912 from theteeth 914. While continuing to compress the spring 916, the grip portion904 may be moved to a desired position on the distal end of the receiverportion 906 and released, causing the teeth 912 and the teeth 914 tomesh to fix the grip portion 904 in the selected position. As the teeth912 and the teeth 914 mesh, the grip portion 904 may move slightly fromthe selected position, in order to reach full engagement of the teeth.The amount of this movement is dependent upon the pitch of the teeth 912and the teeth 914.

In accordance with the provisions of the patent statutes, the principleand mode of operation of this invention have been explained andillustrated in its preferred embodiment. However, it must be understoodthat this invention may be practiced otherwise than as specificallyexplained and illustrated without departing from its spirit or scope.

What is claimed is:
 1. A tool for a surgical instrument, comprising:atubular body having axially extending, diametrically opposed first andsecond yoke arms formed thereon, said first yoke arm and said secondyoke arm each having a respective pivot hole formed therethrough; afirst jaw having a flange portion formed at one end thereof, said flangeportion having first and second opposed faces, a recess being formed insaid first face of said flange portion of said first jaw, a first pivotpin extending perpendicularly from said second face of said flangeportion of said first jaw through said pivot hole in said first yoke armto pivotally mount said first jaw on said body; and a second jaw havinga flange portion formed at one end thereof, said flange portion havingfirst and second opposed faces, a connector pin extendingperpendicularly from said first face of said flange portion of saidsecond jaw, said connector pin extending into said recess formed in saidfirst face of said flange portion of said first jaw to pivotally couplesaid first and second jaws, a second pivot pin extending perpendicularlyfrom said second face of said flange portion of said second jaw throughsaid pivot hole in said second yoke arm to pivotally mount said secondjaw on said body.
 2. The tool defined in claim 1 wherein said connectorpin is received in said recess formed in said first face of said flangeportion of said first jaw with a snap fit.
 3. The tool defined in claim1 wherein each of said jaws is formed of a plastic material and includesa respective metallic contact member fixed thereto.
 4. The tool definedin claim 1, wherein said first and second pivot pins are integrallyformed with said first and second jaws, respectively.
 5. The tooldefined in claim 1, wherein said connector pin is formed integrally withsaid second jaw.
 6. The tool defined in claim 1, wherein said yoke armsare made of plastic.
 7. The tool defined in claim 1, wherein each ofsaid first and second jaws have an elongate gripping portion, each ofsaid elongate gripping portions having an electrical contact fixedthereto, said gripping portions adapted to be connected to a source ofelectrical power.
 8. The tool defined in claim 7, wherein said grippingportions are comprised of plastic and are molded about portions of saidpair of electrical contacts.
 9. A surgical instrument comprising:ahandle having a trigger arm pivotally mounted to said handle; a shaftportion including:a hollow tube having first and second ends, said firstend attached to said handle, and an actuating member disposed withinsaid tube, said actuating member having first and second ends, saidfirst end being attached to said trigger arm; a tool including:a bodyhaving axially extending, diametrically opposed first and second yokearms formed thereon, said body being to be mounted on said second end ofsaid tube of said shaft portion, said first yoke arm and said secondyoke arm each having a respective pivot hole formed therein; a first jawhaving a flange portion formed at one end thereof, said flange portionhaving first and second opposed faces, a recess being formed in saidfirst face of said flange portion of said first jaw, a first pivot pinextending perpendicularly from said second face of said flange portionof said first jaw through said pivot hole in said first yoke arm topivotally mount said first jaw on said body; and a second jaw having aflange portion formed at one end thereof, said flange portion havingfirst and second opposed faces, a connector pin extendingperpendicularly from said first face of said flange portion of saidsecond jaw, said connector pin extending into said recess formed in saidfirst face of said flange portion of said first jaw to pivotally couplesaid first and second jaws, a second pivot pin extending perpendicularlyfrom said second face of said flange portion of said second jaw throughsaid pivot hole in said second yoke arm to pivotally mount said secondjaw on said body; and first and second connector members, said firstconnecting member operatively coupling said flange portion of said firstjaw to said second end of said actuating member, said second connectingmember operatively coupling said flange portion of said second jaw tosaid second end of said actuating member.
 10. The surgical instrumentdefined in claim 9, wherein said first and second connecting members arecomprised of wire.
 11. The surgical instrument defined in claim 10,wherein said first and second connecting members are defined by a pairof end portions of a single length of wire.
 12. The surgical instrumentdefined in claim 9, wherein said body of said tool has a threadedportion cooperating with a mating threaded portion formed on said tubeof said shaft portion, to mount said tubular body on said tube.
 13. Thesurgical instrument defined in claim 9, wherein said first and secondpivot pins are integrally formed with said first and second jaws,respectively.
 14. The surgical instrument defined in claim 9, whereinsaid connector pin is formed integrally with said second jaw.
 15. Thesurgical instrument defined in claim 9, wherein said yoke arms are madeof plastic.
 16. The surgical instrument defined in claim 9, wherein eachof said first and second jaws have an elongate gripping portion, each ofsaid elongate gripping portions having an electrical contact fixedthereto, said gripping portions adapted to be connected to a source ofelectrical power.
 17. The surgical instrument defined in claim 16,wherein said gripping portions are comprised of plastic and are moldedabout portions of said pair of electrical contacts.